Available online at www.sciencedirect.com ScienceDirect

Procedia Technology 20 ( 2015 ) 123 – 132

The International Design Technology Conference, DesTech2015, 29th of June – 1st of July 2015, Geelong, Australia Design of Seamless Knitted Radiation Shielding Garments with 3D Body Scanning Technology

Huda Ahmed Maghrabia,c, Arun Vijayana, Lijing Wanga*, Pradip Debb

aSchool of & , RMIT University, Brunswick, Victoria 3056, Australia bSchool of Medical Sciences, RMIT University, Bundoora, Victoria 3083, Australia cDepartment of Textiles and , Umm Al-Qura University, Mecca 24382, Saudi Arabia

Abstract

Protective aprons for medical use shield against the effects of radiation. The aprons are universally tailored to fit both male and female bodies without due consideration to the differences that abound between masculine and feminine bodies. To date very little emphasis has been shown on the development of aprons to the needs of the female anatomy specifically the breast region as well as consideration of the body shape of pregnant women. This research reviews the needs to develop an X-ray protective garment that is specifically tailored for the female body. Protective aprons designed to fit the female physique incorporating curvature around specific parts of the body namely hip and breast regions as well as the suitability of the apron for use by pregnant women have been explored. Emphasis has been shown on the fit of the garment to impart improved wearer mobility. 3D body scanning technology was used to determine the fit of the developed designs and understand the significance of air gaps between the body and the garment.

© 2015 The Authors. PublishedPublished by by Elsevier Elsevier Ltd. B.V. This is an open access article under the CC BY-NC-ND license Peer-review(http://creativecommons.org/licenses/by-nc-nd/4.0/ under responsibility of School of Engineering,). Faculty of Science Engineering & Built Environment, Deakin University.Peer-review under responsibility of School of Engineering, Faculty of Science Engineering & Built Environment, Deakin University

Keywords: Lead apron; air gap; protective clothing; 3D knitting technology; nylon/wool; seamless technology, 3D Body Scanning.

* Corresponding author. Tel.: +61 3 992 59414. E-mail address: [email protected]

2212-0173 © 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of School of Engineering, Faculty of Science Engineering & Built Environment, Deakin University doi: 10.1016/j.protcy.2015.07.021 124 Huda Ahmed Maghrabi et al. / Procedia Technology 20 ( 2015 ) 123 – 132

1. Introduction

Radiation presents medical personnel with a means for diagnosing patients and for dispensing therapy. While the applications of radiation in medical scenarios are advantageous to society, the associated risks require careful and meticulous handling. Radiation exposure can be harmful to human health. Therefore, radiation protection is crucial for occupational health and safety. Radiation shielding is the most effective way of protection. Pregnant patients, for example, should be aware and cautious about protecting their fetus from X-ray exposure; radiation can cause harm for fetus development. Of similar importance is the female radiographers who should protect their important organs especially the breast area, which is radiosensitive [1]. In the past, the development of radiation protective material has focused on the use of aprons made of lead powder-loaded polymer or elastomer to act as protection against radiation [2]. The challenge that faces such protective aprons is the susceptibility of damage and aging that reduce the apron durability [2]. Recently, shielding fabrics have been produced using matrices made of resin, nano, and micron-scale metallic particles [3]. The particles are made to fuse and interlock with the fabric [3]. As a result, the interlocking produces an impermeable fabric that protects against ionizing radiation [4]. One main problem of this type of apron and vest is that the fabric is not well suited for maneuver [5] [6]. For example, radiographers need to be able to move around, and the traditional “flat” shields make the movement difficult. The purpose of this research work is to develop a true-fit design and provide a more contoured shape with a flexible structure. The design of lead aprons has not changed considerably since the first lead apron was invented more than 100 years ago. The term “apron” historically refers to a sleeveless outer garment that covers the front torso and leg area. The lead apron design has taken similar characteristics of the traditional apron over the years except for few changes including color prints styles, fasteners, and material. The apron design has not had any significant safety modification even though the radiation-induced injuries had been reported in early 20th century [7, 8]. Radiation is a risk factor that is responsible for increased incidence of cancer among healthcare staff working in a radiology department. The US Radiologic Technologist Health Study observed between 1983 and 1998 that there was an increased rate of breast cancer among female radiographers [9]. The study found out that lead aprons provided no protection to the axillary region or the lateral aspect of the breast especially in individuals with large breasts [10]. The leaded garment does not drape well over breasts, and the armholes or arm openings of the apron. It leaves the breasts projected forward, thereby increasing exposure of this radiosensitive area [8]. The outer layer and urethane coating of the lead apron are uncomfortable to wear next to the skin [11]. The coating has a smooth surface that makes the clothing to be easily removed off the surface of the skin. Perhaps the time has come to modify the lead apron with the consideration of the upper female anatomy structure according to White [8]. Comfort is quite a difficult and most of the time elusive component to achieve in the production of a garment [12]. In that regard, despite the fact that the comfort was considered in the design and production of a product, it does not in every circumstance assure that such garment will be comfortable [12]. In most instances, the garment may even fail to achieve a proper fit for the person or the body structure intended for [13]. The fundamental argument is that neither comfort nor the anatomy of the female body was considered for lead aprons. The seamless knitting technology creates a complete garment with no cutting and sewing required. It offers an opportunity for designing and engineering female garments with different body contours. Hence, employing the 3D seamless knitting design for female aprons can produce a garment to fit into the female body structure. Achieving maximum care for the wearer of the protective gear requires that the clothing has a tight grip on the body of the wearer. Further, the analysis of air gaps is fundamental in ensuring that the clothing fit the individuals. The size of the air gaps determines two essential aspects: thermal insulation as well as fit of the clothing. Fitting of protective clothing on the body figure can enhance the protection performance [14]. Also, different studies have found that the garment fit has a great impact on air gap distribution and size [15] [16]. Similar findings by Mah and Song suggest that the size of the air gaps is crucial in thermal protection. Garments that are challenged by fit can have critical impact by reducing its protection purposes [17]. In that respect, the paper draws attention to novel designs for a one-piece garment using the 3D seamless knitting technology as well 3D body scanning to prove their fit for female radiographers.

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1. Materials and Methods

1.1 Fabric design

Table 1 shows the weft-knitted fabric properties designed for the preparation of the prototype protective apron. For the purposes of this paper, wales are referred to as NX, Y represents the courses [18].

Table 1. Fabric properties

Mass per Yarn count Wales Courses Fabric Fabric unit area Construction (tex) (NX)(/cm) (Y)(/cm) thickness (mm) (g/m2) Nylon 940, Weft knitting Nylon/wool 7.20 8.07 1.25 462.8 Wool 41/2 Single

The software employed was the Shima Seiki Whole Garment New SES-S-WG® and the entire garment program, WG-SDS-ONE APEX3 program, was also employed for garment design and engineering. The developed knitted fabric was produced with E14 gauge. The loop length on the fabric was 6.63 mm while the tightness was 30 qualities. The fabric was composed of 940 tex ballistic nylon filament plated with 41/2 count wool yarn on the back face. Nylon is known for its strength, lightweight, resistance to abrasion, resistance to wear and tear. The high strength nylon provides features such as durability and flexibility. In addition, wool in the garment has various advantageous properties that are not limited to comfort, dirt resistance, insulation, resistance to wear and tear. Wool is also known to be non-allergic; hence, it can protect the wearer from possible effects that may harm their health and wellbeing.

1.2 3D body scanner

The models used for the 3D scanning of the female body were size 14 manikins of pregnant and normal female body. A 3D body scanner system made by Textile/ (TC2) was used to develop an accurate representation of the female body figure. The readings, rather, the measurements taken from the manikins were used to develop a comparison of how the measurements of the aprons fit on the naked female manikin body.

1.3 Air gap measurement

Both nude and clothed manikins were scanned, then processed and imported using FreeCAD software. The two scans were aligned based on various points of nodules that shifted slightly in points X, Y, Z see Figure 1. The shifting was paramount in ensuring that the clothes scan perfectly aligned with the nude scan. Several cross sections of slices were then carried out in various positions, but a constant distance of 10 cm was maintained around the bust, and hip area. The correlation between air gap and clothing fit can be extracted by 3D scanning technology [19]. The aim of the investigation was majorly to ensure that the design fits perfectly on the female body figure.

Figure 1. Sample of contour of body and clothing

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1.4 Mass per unit area and material thickness

The mass per unit area of each specimen was measured according to the Australian Standard [20]. The sample dimensions were 100 mm × 100 mm. The material thickness was measured using the AS 1587-1973, Australian standard methods of measuring textile [21]. The arithmetic mean of five measurements was taken.

2. Modelling design

2.1 Sizing of female apron design

The garment designed presents various challenges on of wear and taking off depending on how tight or loose the fabric is on the body. Therefore, determining the right size of the clothing that is worn for a particular body shape and size is essential if the apron is to offer comfort to the wearer. Bearing in mind that the garment design is meant for pregnant women, it is essential that all dimensions of size and body structure are considered in order to come up with the appropriate perfect fit. Figure 2 and Figure 2 illustrate the scanned images and USA sizing system measurements.

Figure 2. (a), (b) Nude body scanning (c), (d) positions for input parameter measurements (e), (f) cloth on scanning and measurement for pregnant manikin

Figure 3. (a), (b) Nude body scanning (c), (d) positions for input parameter measurements (e), (f) cloth on scanning and measurement for normal manikins

The manikins dressed in radiographer were also scanned. The female radiographer consisted of a short-sleeved V-neck and pants. The measurements on the dimensions retrieved are as indicated Huda Ahmed Maghrabi et al. / Procedia Technology 20 ( 2015 ) 123 – 132 127 in Table 2 and Table 3. After the measurements had been taken, the parameters were converted in consideration of the density of the fabric in order to achieve the perfect fit basing on the body size measurements and an estimated ease of allowance. Eventually, the knitting design was based on the measurement calculations for the aprons, i.e. the number of and . The front design and apron knitting sizes were calculated through aggregation of the cloth on measurements. It also incorporated half measurement considerations for the allowance of ease. The conversions were calculated as:         represents the course numbers per cm while  refers to the wales rather the number of needle per cm.  in the equation represents the body size measurement [18].

Table 2. Measurements of input parameters for normal female manikin design and front apron

Measurement (cm) Knitting size (cm) Estimated ease Position Nude Cloth on allowance (cm) NX and Y manikin 1. Neck girth 41 42 1 302.4 - 2. Shoulder length-right 14 14 1 - 112.98 3. Upper bust 101 104 3 748.8 - 4. Bust girth 103 107 4 770.4 - 5. Bust to bust-horizontal 22.0 22.5 0.5 162 - 6. Under bust girth 94 97 3 698.4 - Neck to Waist length- 7. 40 41 1 - 330.87 front 8. Waist girth 79 83 4 597.6 - 9. Armhole length 25 25 1 - 201.75 10. Hip girth 104 108 4 777.6 - 11. Apron length - 113 - - 911.91 12. design length - 46 - - 371.22

Table 3. Measurements of input parameters for knitting pregnant female full front apron

Measurement (cm) Estimated ease Knitting size (cm) Position Nude manikin Cloth on allowance (cm) NX and Y 1. Neck girth 38 39 1 280.8 - 2. Shoulder length-right 13 13 1 - 104.91 3. Upper bust 97 100 3 720 - 4. Bust girth 99 103 4 741.6 - 5. Bust to bust-horizontal 17 18 1 129.6 - 6. Under bust girth 87 90 3 648 - Neck to Waist length- 7. 34 35 1 - 282.45 front 8. Waist girth 106 110 4 792 - 9. Armhole length 23 23 1 - 185.61 10. Hip girth 107 111 4 799.2 - 11. Apron length - 113 - - 911.91 128 Huda Ahmed Maghrabi et al. / Procedia Technology 20 ( 2015 ) 123 – 132

2.2 Knit- package

The knit package consists of three basic packages that are crucial to the process of 3D knitting. Foremost, it consists of the base pattern, secondly, the compressed pattern, thirdly, the development pattern. The three patterns serve essential in the delivery of a complete package. In that regard, the knitting kit is useful in the development of visualized and communicated patterns between 3D and 2D seamless knitting [22]. Color-coding is a central part of the 3D knitting process in which the 3D seamless knitting process takes shape. The 3D apron design incorporates all features of the female body that encompass 2×2 rib both for round collar and for the hem rib. It also contains the bust cup packages. However, the maternity apron consists of adjustments that focus primarily on abdominal area to allow room for the protrusion of the pregnancy. On the other hand, a complete depiction of the 2D design after completion is depicted in Table 4.

Table 4. 2D seamless designs for design and aprons

Knit- Open cup with round collar design Front apron design Maternity (front) apron design package

2D designs for the seamless design and aprons

3. Results and discussion

3.1 3D Knitting technology of different shielding design feature and characteristics

A common 2D pressed pattern was used for all the designs and in the creation of a 3D shape with the transfer stitches technique. The transfer alters the shape and size of the fabrics that eventually develop the shape [22]. An important feature of the design was that it can either be worn on of or underclothing such as medical scrub or can be worn directly on the body without any underclothing. Half ease allowance is helpful in increasing the front garment in absence of undergarments. Subsequently, increasing from the cup darts in the 2D design required an addition of  number to the start and the end. That was done in order to determine the needed width for the bust and hip regions. The process is then repeated severally for other parts such as the abdominal regions having in mind that the central objective is to achieve a smooth and soft shape of a dome. The procedure is similar for the length of the design although quite different from the front apron process. An analysis of the design’s effectiveness as observed from the 3D scanner reveals that the designs fit well on the manikins for both pregnant and non-pregnant manikin subjects. Furthermore, the apron designs are promising in that they appear comfortable to wear as well as being able to deliver on the aspect of protection of the body from radiation. On the other hand, there are other factors that require consideration such as comfort, style, duration, purpose, and wear etc. Table 5 shows a collection of features and characteristics of garment designs for females.

Huda Ahmed Maghrabi et al. / Procedia Technology 20 ( 2015 ) 123 – 132 129

Table 5. Female designs feature and characteristics Design feature 3D body scanning Function of design Open cup with round collar design • This design can be used for mammography examination.

• Women who suffer from breast cancer or need to go for radiation therapy.

• The open cup design helps to open one side of the breast to be expose to radiation while cover the other side with pad to provide more protection (a) (b) to this sensitive organ from scatter or leakage radiation.

• This design can be used by female patients worn on upper torso without any cloth (I) (II) (III) underneath.

• This design joined with strips on each side and from shoulder line. The round collar (c) (d) will add more advantage to the thyroid area for patients.

• The (e) bra pad design will complete the work with design

(e)

Front apron design

• Full protection for CT or fluoroscopy examination for female radiographer.

• This design can be worn on top of medical scrub.

• The round collar will add advantage to protect the thyroid area from scatter (I) radiation. (a) (b) (c) (II) (III)

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Maternity front apron design • Full protection for CT or fluoroscopy examination for pregnant radiographers.

• This design can be worn on top of medical scrub.

• The round collar will add advantage to protect the thyroid area from scatter radiation.

(a) (b) (c) (I) (II) (III)

3.2 Air gap measurement

The FreeCAD software was used for the analysis of the air gaps between the nude manikin and the garment and the design based on the girth of bust, waist, and hip. An analysis of the garment fit was achieved through an alignment of the nude and clothed scans of the manikins by overlapping them on each other. Resultantly, the successful alignment of the two meant that minimal changes were made in the positions of the clothed and nude scans. Figure 4 shows the average air gap size of scanned open cup and garments developed. The waist girth indicates the smallest air gap by 14 mm for the open cup design and 15 mm for the front apron on normal manikin, and 21 mm for the pregnant manikin, suggesting that the fabric in this region fitted better than other regions. This induction might be because of there is only one layer of the t-shirt under the apron. The large area of the abdominal region for pregnant manikin explains the large gap among all designs. The bust girth was achieved by using the largest air gap for the pregnant manikin with 32 mm, then, the normal manikin by 25 mm and 18 mm for the open cup design. It should be noted that the open cup design was placed on the normal manikin without any cloth underneath because this design will be next to the skin for mammographic examination. Moreover, the large air gaps indicate slight looseness for these designs because fabric layers will fill in the gap underneath the aprons. There are no recommendations in the literature to determine the perfect air gap size for apron as protective clothing. The fitting mainly depends on the body posture and the body parts geometry as well garment layer and drape.

Figure 4. Air gap size for design and aprons design from three different slices

Eventually, the calculations of the hip girth were done for the front apron as well as for the maternity apron. In the case of the front apron, the measurement taken was 18 mm while the latter was 25 mm. The three designs of the front, maternity and non-pregnant aprons reveal that the average air gap is larger than the open cup design style. Huda Ahmed Maghrabi et al. / Procedia Technology 20 ( 2015 ) 123 – 132 131

This is due to the medical scrub uniform worn underneath which was found to decrease the drape of the fabric owing to wrinkles on the undergarments worn beneath the apron. Equally, coupled with clothing folds, the average air gap of the aprons increased. Therefore, there is a need for further analysis of the common effect of fabric property and clothing size on the air gap size. Furthermore, the number of fabric layers is also crucial during the analysis as various characteristic features e.g. flexibility and elasticity affect the size of air gaps that are entrapped within [16]. Since the air gap and the thermal insulation had a directly proportional relationship, when an air gap exceeded 1cm thick the thermal insulation would decrease with an increase in the air gap and vice versa [23]. In addition, a further study is needed to determine how much air gap is adequate for well-fitting protective clothing and how this can provide a good level of protection during duty time. Several combinations of fabric/fibre composition, physical and mechanical properties of fabric, the number of layers, design of clothing, heat flux, air volume and moisture present that can have vital impact on thermal comfort, and can affect the required thickness of the air layer [14] [15] [23]. To that end, a well-fitted clothing, rather an apron makes the mobility of the wearer easily achievable [24].

3.3 Fabric properties

The knitted fabric thickness is 1.25 mm as shown in Table 1. The mass per unit are for the nylon/wool ballistic fabric is 462.8 g/m2, which is coincidentally also the medium weight. The wool yarn count was 41/2. The wool yarn was plated on the back of the fabric, see Figure 5. In addition, a 940 tex nylon yarn was knit on the front face of the fabric. The nylon was employed in the knitting process. This combination of two yarns resulted in a thicker fabric due to the twisted wool fibre. The fibre used does not have much radiation shielding capability. This report is to demonstrate the design concept only. Radiation shielding yarns will be used to produce protective garments and radiation shielding coating will also be attempted to enhance the shielding protection performance.

(a) (b)

Figure 5. (a) Face surface of Nylon plated with wool fabric (b) Back surface of wool- nylon fabric

Conclusion

Protective clothing against radiation is very important for individuals especially females since it protects their breasts and pregnancies from the effects of radiation. Currently, the limited range of protective aprons consequently does not have provisions that place into consideration the physique of the feminine body. This work developed unique and basic designs of garments for protecting medical practitioners and patients against radiation. The study presents alternative aprons that can be worn by female medical practitioners in three designs namely open cup with round collar design, front apron and maternity apron that will suit the female body features majorly the breast, waist, and hip regions. The garment design is based on a 3D scan technology of the female body to put into perspective the features of the female body. As such, the apron then fits effectively on the body of the female practitioners since its design is tailored to incorporate all the features of the female body. Further research is warranted to gain a better understanding of radiation shielding performance by coating the developed garments with suitable radiation shielding materials, then assessing their comfort properties such as thermal moisture vapour resistance and sensorial; and physical properties such as drape, fabric stiffness and bending rigidity.

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